ArticleDEN open2026
Diagnostic Value of Endoscopic Ultrasound-Guided Tissue Acquisition With Rapid On-Site Evaluation in Small Gastric Subepithelial Lesions.
Article in DEN open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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12 authors.
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Abstract
Background: Gastric subepithelial lesions (SELs) measuring <20 mm without high-risk features are typically managed with periodic surveillance, while surgical resection is recommended for gastrointestinal stromal tumors (GISTs) per the Japanese guideline. Recent advancements in endoscopic ultrasound-guided tissue acquisition (EUS-TA) needles have improved tissue collection, but few studies have assessed the utility of EUS-TA for SELs <20 mm. This study aimed to evaluate the usefulness of EUS-TA for gastric SELs <20 mm. Methods: We retrospectively analyzed patients who underwent EUS-TA for SELs at Tonan Hospital between June 2012 and March 2025. Variables including needle type, number of passes, histological diagnosis, and diagnostic accuracy were compared between SELs <20 and ≥20 mm. Rapid On-Site Evaluation (ROSE) was performed for all specimens. Results: A total of 163 patients were included: 50 with SELs <20 mm and 113 with SELs ≥20 mm. Median lesion size was 15.5 and 31.7 mm, respectively. The <20 mm group required more passes to obtain adequate samples (2.5 vs. 2.0, Conclusions: EUS-TA with ROSE for gastric SELs <20 mm yields diagnostic accuracy comparable to that for SELs ≥20 mm. Given the high GIST prevalence in small SELs, EUS-TA may be a valuable diagnostic strategy.
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